Intestinal malrotation is a constellation of a wide spectrum of embryologic failures of rotation and fixation of the gut, resulting in a narrow-based attachment of the mesentery and the presence of abnormal peritoneal (Ladd's) band. These abnormalities predispose to midgut volvulus, intestinal obstruction and internal herniation. We experienced a case of intestinal malrotation complicated by midgut volvulus in a 4-year-old girl who presente with abdominal pain, abdominal distension and melena. The diagnosis was made by abdominal CT scan, which showed "whirl sign." The diagnosis was confirmed by surgery. A brief review of literature ensues.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

Intestinal malrotation is a constellation of a wide spectrum of embryologic failures of rotation and fixation of the gut, resulting in a narrow-based attachment of the mesentery and the presence of abnormal peritoneal (Ladd's) band. These abnormalities predispose to midgut volvulus, intestinal obstruction and internal herniation. We experienced a case of intestinal malrotation complicated by midgut volvulus in a 4-year-old girl who presente with abdominal pain, abdominal distension and melena. The diagnosis was made by abdominal CT scan, which showed "whirl sign." The diagnosis was confirmed by surgery. A brief review of literature ensues.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

Idiopathic long QT syndrome(LQTS) is an important cause of syncope, seizures, serious ventricular arrhythmias and sudden death in children. The abnormalities of AV conduction such as 2:1 AV block in children with LQTS is rarely reported. We reported two cases of 2:1 atrioventricualr block in infants with LQTS. Patient 1, a female newborn, revealed bradycardia(60 beats/min) and QTc of 0.65sec with 2:1 AV block at birth. She died of polymorphic ventricular tachycardia at 26days of age. Patient 2, a 2-month-old female, exhibited prolonged QT interval (QTc=0.54sec), 2:1 AV block, and intermittent Wenckebach conduction. After she received propranolol, sinus rhythm with 1:1 AV conduction and QTc of 0.5sec was seen. After a follow-up of 6 months, the infant is still doing well.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Child ; Death, Sudden ; Female ; Follow-Up Studies ; Humans ; Infant* ; Infant, Newborn ; Long QT Syndrome* ; Parturition ; Propranolol ; Seizures ; Syncope ; Tachycardia, Ventricular

Bronchial mucoepidermoid carcinoma is very rarely encountered in children. We report a case of bronchial mucoepidermoid carcinoma in a 10-year-old boy who presented with persistent cough and atelectasis. Bronchoscopic examination showed a tumor mass occluding the right bronchus intermedius, and the mass was removed by bronchoscopy. The results of the pathological examination revealed low-grade mucoepidermoid carcinoma. He underwent right middle and lower lobectomy with bronchoplasty, and there was no metastasis. He remains symptom-free without recurrence of bronchial tumor during the follow-up period of 12 months.
Bronchi ; Bronchoscopy ; Carcinoma, Mucoepidermoid* ; Child* ; Cough ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Pulmonary Atelectasis ; Recurrence

PURPOSE: Food allergy is one of the common allergic diseases and elicits various clinical manifestations in children. Although the offending food could be suspected by history of food allergy and skin test with food allergen, it should be confirmed by food challenge test. We investigated the result of open food challenge test(OFCT) with offending food as suspected by history and/or skin test. Thereafter we analyzed the relationship between positive history of food allergy and positive skin test to food allergen, and positive food challenge test. METHODS: The subjects consisted of 208 children (age range, 3-15 years) with history of food allergy and/or positive skin test to food allergen. Open food challenge test was performed in 276 cases with 33 kinds of suspected foods. Increasing doses of natural food were given every 20 minutes, and the clinical manifestations elicited by challenge test were observed for 1 hour. RESULTS: 1) One-hundred twenty eight of 276 cases were positive for OFCT, and the provocation rate was 46.4%. 2) The provocation rate of individual food was highest in buckwheat flour(72.3%), followed by crab(60.0%), shrimp(45.8%), milk(41.6%), and egg(41.4%). 3) OFCT elicited allergic manifestations in 44.8% of positive history alone and 31.1% of positive skin test alone. Allergic manifestations were elicited in 91.2% when both the positive history and skin test were positive for the same food. 4) Positive and negative predictive values for OFCT were 67.8% and 68.9% in history, 46.8% and 55.2% in skin test, and 91.2% and 65.3% in history and skin test respectively. 5) Urticaria was the most common symptom(84.4%) elicited by OFCT. There were various allergic manifestations such as asthma, rhinitis, conjunctivitis and burning sensation in throat. Anaphylactic shock was observed in 3 cases with buckwheat flour allergy. 6) For the most cases(51.5%) symptoms occurred by the ingestion of small amount(1-100gm) of offending food. But symptoms in 27 cases were elicited just by scrubbing the food on lips or licking it by tongue. CONCLUSIONS: Open food challenge test showed the highest positive provocation rate with buckwheat. The most common symptom was urticaria, which was elicited with only a small amount of offending food. In predicting the result of OFCT, food allergy history was more reliable than the positive skin test, and if both the history and the skin test were positive for the same food, almost all the cases showed positive results with OFCT.
Anaphylaxis ; Asthma ; Burns ; Child ; Conjunctivitis ; Eating ; Fagopyrum ; Flour ; Food Hypersensitivity* ; Humans ; Hypersensitivity ; Lip ; Pharynx ; Rhinitis ; Sensation ; Skin Tests* ; Skin* ; Tongue ; Urticaria

There were 105 patients with multiple rib fracture or flail chest who had underwent surgical rib fixation using Judet's strut from Aug. 1989 to Aug. 1995. They were 86 men and 19 women, and the age distribution was from 17 to 77(mean 48+/-12). The most common cause of accident was a traffic accident(81%). The mean number of rib fracture was 5.5 and the distribution of patient were flail chest(72, 64.7%), severe displaced rib Fracture(18, 17.1%), traumatic chest wall deformity(10, 95%) and others(5, 4.7%). The operative mortality was 1 patient(0.96%) and the incidence of postoperative complication were 13 patients(12.3%). The duration of perioperative artificial ventilator therapy was 90.5+/-22.6 hours. Our method allowed shorter duration of an artificial ventilation and decreased a functional sequelae. We find this technique to be better than previously published methods, since it provides better stabilization and immobilization of the ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.
Age Distribution ; Congenital Abnormalities ; Female ; Flail Chest* ; Humans ; Immobilization ; Incidence ; Male ; Mortality ; Postoperative Complications ; Rib Fractures* ; Ribs* ; Thoracic Wall ; Thorax ; Ventilation ; Ventilators, Mechanical

No abstract available.
Humans ; KB Cells* ; NADP* ; NADPH Oxidase ; Oxidoreductases* ; Porphyromonas gingivalis* ; Porphyromonas*

Actinomycosis is a rare entity which presents some difficulties in establishing a correct preoperative diagnosis. Many actinomycotic pelvic infections in women are related to IUD use and the colonization rate appears to increase in accordance with the duration of IUD use. So, all women in IUD use are recommended to make cervicovaginal smear and pelvic infection associated with IUD use should be suspected to have actinomycoses. We report a case which presented painful mass on right upper and lower quadrant of abdomen of a 40-year-old women. We identified sulfur granules by histopathologic exam of surgically resected specimen. Eventually it proved to be pelvic and abdominal actinomycosis associated with the use of an intrauterine device. Because variable clinical pictures and infrequency of the disease make the diagnosis more difficult, increased alertness of clinicians and microbiologists to the presence of anaerobic organism as the cause of infection are needed to make an earlier and more correct diagnosis of actinomycoses and to further avoid any inappropriate treatment.
Abdomen ; Actinomycosis ; Adult ; Colon ; Diagnosis ; Female ; Humans ; Intrauterine Devices ; Pelvic Infection ; Pelvis ; Sulfur

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus oral dinoprostone for labor induction at term. METHODS: One hundred of patients at term were randomized to receive either 50microgram of misoprostol vaginally every 4 hours or dinoprostone 0.5mg orally every 1 hour for the maximum of six doses. Intravenous infusion of oxytocin was administered under such circumferences as the patient did not go into active labor after maximum dose, SROM was developed without an adequate contraction pattern, or the patient had arrest of dilatation(no change in cervical dilatation for 2 hours). We compared the frequency of oxytocin augmentation, administration to delivery interval, vaginal delivery rate within 12 hours and 24 hours, intrapartum complications, induction failure, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: The average interval from administration to delivery was shorter in the misoprostol group(739.4+/-372.4min vs 1087.7+/-765.1min, p<0.05), but the interval from administration to vaginal delivery of each group was similar(724.3+/-375.4min vs 800.3+/-697.0min). Regarding the frequency of vaginal delivery within 24 hours, however, misoprostol group was higher than dinoprostone group(88% vs 56%, p<0.001). And oxytocin augmentation of labor occurred less commonly in misoprostol group than in dinoprostone group(20% vs 76%, p<0.05). Any statistically significant difference in intrapartum complications, mode of delivery, and neonatal or maternal adverse outcome was not appeared between these two group. CONCLUSION: Vaginal misoprostol is as effective and safe as oral dinoprostone for cervical ripening and induction of labor at term. In addition, vaginal misoprostol contributes the curtailment of labor induction expenditure due to its moderate price; misoprostol costs 100 won per 50microgram.
Cervical Ripening ; Dinoprostone* ; Female ; Health Expenditures ; Humans ; Infusions, Intravenous ; Labor Stage, First ; Misoprostol* ; Oxytocin ; Pregnancy

PURPOSE: Objective of this study is to determine changes in the levels of type I and III collagen in women with stress urinary incontinence (SUI). MATERIALS AND METHODS: Forty-nine women were enrolled to this study and e divided into two groups. Forty-four patients with SUI and 5 patients with without SUI for control. All the women were underwent a pre-operative evaluation. The presence of collagen type I and III was determined by immunohistochemical technique. Analysis of staining was studied with help of specialist of pathology with Image Pro computerized program. The student t-test was used for statistical analysis. RESULTS: Collagen type I and III was significantly reduced (p<0.05) in patients with SUI in anterior vaginal wall tissue. compared to patients in control. Both collagen type I and III were marked reduced in the patient of severe grade of stress urinary incontinence. However there were no significant relation between quantity of collagen and other etiological factors including age, parity, grade, and menopausal. CONCLUSION: In this study, women with SUI have less collagen type I and III around the urethra regardless of the degree of pelvic relaxation, SUI grade, parity, menopausal, age. It appears that collagen has a significant role in the maintenance of urinary continence.
Collagen Type I ; Collagen* ; Female* ; Humans ; Parity ; Pathology ; Relaxation ; Specialization ; Urethra ; Urinary Incontinence*